An antibody treatment reduces the rate of flare-ups by nearly 20 per cent in patients with a subgroup of treatment-resistant chronic obstructive pulmonary disease (COPD), according to the results of two large international trials presented at the European Respiratory Society International Congress in Milan, Italy, and simultaneously published in the New England Journal of Medicine.
‘The goal of precision medicine is to give the right treatment to the right patient,’ said lead author Frank Sciurba, MD, Director of the Centre For COPD and Emphysema and UPMC Pulmonary Function Exercise Physiology Laboratory, and visiting Professor in the Division of Pulmonary, Allergy, and
Critical Care Medicine, University of Pittsburgh School of Medicine.
‘These findings are the first example of a precision therapy that is uniquely effective in a subgroup of patients with treatment-resistant COPD.’
‘There is significant variation between patients in the cells and other proteins responsible for lung inflammation, so there are actually many different subtypes of COPD,’ said Sciurba.
‘One subgroup called eosinophilic predominant COPD is present in as many as 40 per cent of patients and is characterised by elevated levels of a type of white blood cell known as eosinophils.’
The new study reports the results from two Phase III clinical trials evaluating the efficacy of mepolizumab, an antibody treatment that reduces the number of eosinophils in the blood, in moderate-to-severe treatment-resistant eosinophilic COPD by blocking the pro-inflammatory effects of interleukin-5.
Patients included in the trials were still having flare-ups despite a year of a standard treatment known as ‘triple inhaled therapy’ that includes bronchodilators and glucocorticoids.
‘These patients already have been given every treatment we have to offer them and are still having flare-ups that significantly interfere with their quality of life and can lead to deterioration in lung function and higher mortality,’ commented Sciurba.
‘We hoped to be able to offer them an option.’